He Bin, Gai Luyue, Gai Jingjing, Qiao Huaiyu, Zhang Shuoyang, Guan Zhiwei, Yang Li, Chen Yundai
Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
Exp Clin Cardiol. 2013 Spring;18(2):e71-6.
Unstable plaque is believed to be responsible for major adverse cardiac events (MACE).
To determine whether coronary computed tomography angiography (CCTA) could be used to predict future MACE.
Patients undergoing CCTA between January 2008 and February 2010 were consecutively enrolled in the study. The hospital database was screened for patients who later developed acute ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or cardiac death. Plaque scores were calculated and analyzed using one-way ANOVA to examine the relationship between plaque scores and MACE.
Of the 8557 patients who underwent CCTA, 1055 had hospital records available for follow-up. During follow-up, 25 patients experienced MACE including death (six patients), heart failure (two patients), STEMI (11 patients) and NSTEMI (six patients). The plaque scores were significantly increased in patients who later died, developed heart failure or experienced STEMI (P<0.05). Calcification, erosion and severe stenosis were responsible for the events (P<0.05). Mild and moderate lesions, positive remodelling, drug-eluting stent placement, occlusion and diffuse lesions were not predictive of MACE (P>0.05).
Severe calcification, erosion and severe stenosis predict death, heart failure and STEMI.
不稳定斑块被认为是主要不良心脏事件（MACE）的原因。
确定冠状动脉计算机断层扫描血管造影（CCTA）是否可用于预测未来的MACE。
连续纳入2008年1月至2010年2月期间接受CCTA的患者。在医院数据库中筛选后来发生急性ST段抬高型心肌梗死（STEMI）、非STEMI（NSTEMI）或心源性死亡的患者。计算斑块评分并使用单因素方差分析进行分析，以检验斑块评分与MACE之间的关系。
在8557例接受CCTA的患者中，1055例有可用于随访的医院记录。随访期间，25例患者发生MACE，包括死亡（6例）、心力衰竭（2例）、STEMI（11例）和NSTEMI（6例）。后来死亡、发生心力衰竭或经历STEMI的患者斑块评分显著升高（P<0.05）。钙化、糜烂和严重狭窄是导致这些事件的原因（P<0.05）。轻度和中度病变、阳性重构、药物洗脱支架置入、闭塞和弥漫性病变不能预测MACE（P>0.05）。
严重钙化、糜烂和严重狭窄可预测死亡、心力衰竭和STEMI。
